First Endocrinologist Appointment: My Brain is Broken

First Endocrinologist Appointment: My Brain is Broken

When I got my initial referral, and found out I was looking at a 3 month wait time, I was… perturbed.

Then I remembered that my girlfriend is the most well connected Melbournian in the world. She asked a few people who asked a few people and hey presto, someone had a cancellation and they were available in 2 days.

Boom.

Hypogonadotropic hypogonadism.

What does that mean? Hypogonadism means ones testes aren’t producing. And Hypogonadotropic hypogonadism is a form of hypogonadism caused by a pituitary or hypothalmic deficiency.

FSH and LH

Brain.

Maybe we should take a step back…

There are a few steps involved here.

The hypothalamus prompts the pituitary gland, a pea-sized thing in your head, to produce Leutenising Hormone (LH) and Follicle Stimulating Hormone (FSH).

LH stimulates testosterone production in the testes. FSH stimulates sperm production.

My LH is <1, where the normal range is 2-8 IU/L. Which is low. My FSH is 2 IU/L, where 1-8 is the normal range. So FSH is normal, LH is low. Apparently one would expect FSH to be very high if LH was low, but mine is not. Medical mystery #1.

My serum testosterone is 1.4 nmol/L (normal range 6-28), and my free testosterone is 42 pmol/L (normal range 200-600).

This is not good.

Dr. Nolan

Prolactin

Finally, there’s prolactin. This is the hormone that triggers the production of breast milk. All men have it. The normal range is 45-375mIU/L – mine is 127. Normal! Hooray!

Except that one reason for the low testosterone would also create high prolactin… so this only confuses things.

Prime Candidate

At the moment the most likely offender is a pituitary tumor. Except my FSH is normal, as is my prolactin. So while it is the most likely offender, it’s not actually that likely.

Next Steps

The next step is an MRI to see if there’s anything obvious growing in my noggin that really shouldn’t be.

2 thoughts on “First Endocrinologist Appointment: My Brain is Broken”

  1. Avatar
    Dominique Le Sellin

    Jeez, that is a bit scary!! I hope it all works out well. How did you find out there was something wrong in the 1st place? I just found out that there is a benign tumor in one of my adrenal gland (gland the regulates potassium, salt in your blood, in order to control the blood pressure). Lucky I got a very conscientious doctor. I’ll have an op in the next 3 to 6 months ;-( Good luck to you Dom

    1. Jake

      Hey Dom! The radiologist report said that at some point I’ve had some physical trauma – rugby, motorbike crash, explosion etc – that has caused a brain bleed onto the pituitary and has caused a part of it to die and shrink away. And that while they don’t yet understand why this happens, it has resulting in one hormone not being produced.

      I’m glad to hear you got a conscientious doctor! (I found one eventually.) Best of luck with the operation, let me know how it goes.

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